| NPI | 1669141420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY STUMP CEO/Owner 304-237-2339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2021-09-07 |